<div class="am-u-sm-12 widget" style="margin:10px ;">

	<form class="am-form-inline tpl-form-border-form" enctype="multipart/form-data" data-check="1" data-ajax="1">
		<input type="hidden" name="refuel_record_id" value="{$item.refuel_record_id}" />
		<div class="am-u-sm-8">
			<div class="am-u-sm-12" style="margin-bottom:10px ;">
				<div class="am-u-sm-6 cl-p">
					<label class="am-u-sm-4 am-form-label cl-p" style="line-height: 35px;">车牌号： </label>

					<div class="am-u-sm-8 cl-p">
						<input type="hidden" class="CarId" name="car_id" value="{$item.car_id}" />
						<input type="text" class="am-form-field tpl-form-no-bg  car_number" value="{$item.number}"  data-check='require' data-msg="车牌号不能为空" readonly="" />
					</div>
				</div>
				<div class="am-u-sm-6 cl-p">
					<label class="am-u-sm-4 am-form-label cl-p" style="line-height: 35px;">加油司机： </label>
					<div class="am-form-group am-u-sm-8 cl-p">
						<div class="am-u-sm-12 cl-p">
							<input type="hidden" class="driver_id" name="driver_id" value="{$item.driver_id}" />
							<input type="text" class="am-form-field tpl-form-no-bg  driver"  value="{$item.name}"  data-check='require' data-msg="加油司机不能为空" readonly="">
						</div>
					</div>
				</div>
			</div>

			<div class="am-u-sm-12" style="margin-bottom:10px ;">

				<div class="am-u-sm-6 cl-p">
					<label class="am-u-sm-4 am-form-label cl-p" style="line-height: 35px;">汽油油号： </label>
					<div class="am-form-group am-u-sm-8 cl-p">
						<div class="am-u-sm-12 cl-p">
							<select name="label" class="label" >
								{$labels}
							</select>
						</div>
					</div>
				</div>
				<div class="am-u-sm-6 cl-p">
					<label class="am-u-sm-4 am-form-label cl-p" style="line-height: 35px;">加油量(升)： </label>
					<div class="am-form-group am-u-sm-8 cl-p">
						<div class="am-u-sm-12 cl-p">
							<input type="number" class="tpl-form-input" name="litre" value="{$item.litre}"  data-check='require' data-msg="加油量不能为空"/>
						</div>
					</div>
				</div>
			</div>
			<div class="am-u-sm-12" style="margin-bottom:10px ;">
				<div class="am-u-sm-6 cl-p">
					<label class="am-u-sm-4 am-form-label cl-p" style="line-height: 35px;">加油费用： </label>
					<div class="am-form-group am-u-sm-8 cl-p" style="padding-left: 3px;">
						<div class="am-u-sm-12 cl-p">
							<input type="number" class="tpl-form-input" name="price" value="{$item.price}"  data-check='require' data-msg="加油费用不能为空"/>
						</div>
					</div>
				</div>
				<div class="am-u-sm-6 cl-p">
					<label class="am-u-sm-4 am-form-label cl-p" style="line-height: 35px;">加油日期： </label>
					<div class="am-form-group am-u-sm-8 cl-p">
						<div class="am-u-sm-12 cl-p">
							<input type="text" class="tpl-form-no-bg" name="start_date" value="{$item.start_date}"  data-check='require' data-msg="加油日期不能为空" placeholder="发布时间" data-am-datepicker="" readonly="">
						</div>
					</div>
				</div>
			</div>

			<div class="am-u-sm-12" style="margin-bottom:10px ;">

				<div class="am-u-sm-6 cl-p">
					<label class="am-u-sm-4 am-form-label cl-p" style="line-height: 35px;">加油地点： </label>
					<div class="am-form-group am-u-sm-8 cl-p" style="padding-left: 3px;">
						<div class="am-u-sm-12 cl-p">
							<input type="text" class="tpl-form-input" name="refuel_add" value="{$item.refuel_add}"  data-check='require' data-msg="加油地点不能为空"/>
						</div>
					</div>
				</div>
				<div class="am-u-sm-6 cl-p">
					<label class="am-u-sm-4 am-form-label cl-p" style="line-height: 35px;">加油站： </label>
					<div class="am-form-group am-u-sm-8 cl-p">
						<div class="am-u-sm-12 cl-p">
							<input type="text" class="tpl-form-input" name="gas_station" value="{$item.gas_station}"  data-check='require' data-msg="加油站不能为空"/>
						</div>
					</div>
				</div>
			</div>
			<div class="am-u-sm-12" style="margin-bottom:10px ;">
				<div class="am-u-sm-6 cl-p">
					<label class="am-u-sm-4 am-form-label cl-p" style="line-height: 35px;">加油员： </label>
					<div class="am-form-group am-u-sm-8 cl-p" style="padding-left: 3px;">
						<div class="am-u-sm-12 cl-p">
							<input type="text" class="tpl-form-input" name="fuel_man" value="{$item.fuel_man}"  data-check='require' data-msg="加油员不能为空"/>
						</div>
					</div>
				</div>
				<div class="am-u-sm-6 cl-p">
					<label class="am-u-sm-4 am-form-label cl-p" style="line-height: 35px;">联系电话： </label>
					<div class="am-form-group am-u-sm-8 cl-p">
						<div class="am-u-sm-12 cl-p">
							<input type="number" class="tpl-form-input" name="phone" value="{$item.phone}"  data-check='require' data-msg="联系电话不能为空"/>
						</div>
					</div>
				</div>
			</div>
			<div class="am-u-sm-12" style="margin-bottom:10px ;">
				<div class="am-u-sm-12 cl-p">
					<label class="am-u-sm-2 am-form-label cl-p" style="line-height: 35px;">备注说明： </label>
					<div class="am-form-group am-u-sm-10 cl-p">
						<div class="am-u-sm-12 cl-p">
							<textarea class="" rows="10" id="user-intro" name="ps" placeholder="请输入文章内容">{$item.ps}</textarea>
						</div>
					</div>
				</div>
			</div>
			<div class="am-u-sm-12" style="margin-bottom:10px ;">
				<div class="am-form-group am-u-sm-6 cl-p">
					<label class="am-u-sm-4 am-form-label am-text-truncate cl-p">加油记录照片：</label>
					<div class="am-u-sm-8 ">
						<div class="am-u-sm-12">

							<div class="am-form-group am-u-sm-3 ">

								<div class="am-u-sm-10 am-margin-top-xs">
									<div class="am-form-group am-form-file showimg">
										<div class="tpl-form-file-img">
											<img src="{:CxImg($item.img)}" alt="加油记录照片">
										</div>
										<button type="button" class="am-btn am-btn-danger am-btn-sm "><i class="am-icon-cloud-upload"></i> 添加加油记录照片</button>
										<input id="doc-form-file" type="file" name="img">
									</div>

								</div>
							</div>

						</div>
					</div>
				</div>

			</div>
			<div class="am-u-sm-12" style="margin-bottom:10px ;">
				<div class="am-u-sm-4">&nbsp;</div>
				<div class="am-u-sm-4">
					<button type="button" class="am-btn am-btn-sm am-btn-primary am-radius keep">保存</button>
					<a class="am-btn am-btn-sm am-btn-secondary am-radius back">返回上一页</a>
				</div>
				<div class="am-u-sm-4">&nbsp;</div>
			</div>
		</div>
	</form>
</div>